TY - JOUR
T1 - Trauma Associated Sleep Disorder
T2 - Clinical Developments 5 Years After Discovery
AU - Brock, Matthew S.
AU - Powell, Tyler A.
AU - Creamer, Jennifer L.
AU - Moore, Brian A.
AU - Mysliwiec, Vincent
N1 - Publisher Copyright:
© 2019, This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Purpose of Review: We review recent and growing evidence that provides support for a novel parasomnia, trauma associated sleep disorder (TASD). Based on these findings, we further develop the clinical and polysomnographic (PSG) characteristics of TASD. We also address factors that precipitate TASD, develop a differential diagnosis, discuss therapy, and propose future directions for research. Recent Findings: Nightmares, classically a REM phenomenon, are prevalent and underreported, even in individuals with trauma exposure. When specifically queried, trauma-related nightmares (TRN) are frequently associated with disruptive nocturnal behaviors (DNB), consistent with TASD. Capture of DNB in the lab is rare but ambulatory monitoring reveals dynamic autonomic concomitants associated with disturbed dreaming. TRN may be reported in NREM as well as REM sleep, though associated respiratory events may confound this finding. Further, dream content is more distressing in REM. Therapy for this complex disorder likely requires addressing not only the specific TASD components of TRN and DNB but comorbid sleep disorders. Summary: TASD is a unique parasomnia developing after trauma. Trauma-exposed individuals should be specifically asked about their sleep and if they have nightmares with or without DNB. Patients who report TRN warrant in-lab PSG as part of their evaluation.
AB - Purpose of Review: We review recent and growing evidence that provides support for a novel parasomnia, trauma associated sleep disorder (TASD). Based on these findings, we further develop the clinical and polysomnographic (PSG) characteristics of TASD. We also address factors that precipitate TASD, develop a differential diagnosis, discuss therapy, and propose future directions for research. Recent Findings: Nightmares, classically a REM phenomenon, are prevalent and underreported, even in individuals with trauma exposure. When specifically queried, trauma-related nightmares (TRN) are frequently associated with disruptive nocturnal behaviors (DNB), consistent with TASD. Capture of DNB in the lab is rare but ambulatory monitoring reveals dynamic autonomic concomitants associated with disturbed dreaming. TRN may be reported in NREM as well as REM sleep, though associated respiratory events may confound this finding. Further, dream content is more distressing in REM. Therapy for this complex disorder likely requires addressing not only the specific TASD components of TRN and DNB but comorbid sleep disorders. Summary: TASD is a unique parasomnia developing after trauma. Trauma-exposed individuals should be specifically asked about their sleep and if they have nightmares with or without DNB. Patients who report TRN warrant in-lab PSG as part of their evaluation.
KW - Disruptive nocturnal behaviors
KW - Nightmares
KW - Trauma associated sleep disorder
KW - Trauma-related nightmares
UR - http://www.scopus.com/inward/record.url?scp=85070672019&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85070672019&partnerID=8YFLogxK
U2 - 10.1007/s11920-019-1066-4
DO - 10.1007/s11920-019-1066-4
M3 - Review article
C2 - 31410580
AN - SCOPUS:85070672019
SN - 1523-3812
VL - 21
JO - Current psychiatry reports
JF - Current psychiatry reports
IS - 9
M1 - 80
ER -